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CERTIFICATE OF LIABILITY INSURANCE <br />DATE (MM/DD/YYYY) <br />07/08/2021 <br />THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE <br />HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND,EXTEND OR ALTER THE COVERAGE <br />AFFORDED BY THE POLICIES BELOW.THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE <br />ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. <br />IMPORTANT:If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must be endorsed.If SUBROGATIONIS WAIVED, <br />subject to the terms and conditions of the policy,certain policies may require an endorsement.A statement on this certificate does <br />not confer rights to the certificate holder in lieu of such endorsement(s). <br />PRODUCER <br />HUB INTERNATIONAL MIDWEST LTD <br />02025586 <br />55 EAST JACKSON BOULEVARD 14A <br />CHICAGO IL 60604 <br />CONTACT NAME: <br />PHONE <br />(A/C, No, Ext): <br />(312) 279-4690 FAX <br />(A/C, No): <br />(866) 618-3958 <br />E-MAIL ADDRESS: <br />INSURER(S) AFFORDING COVERAGE NAIC# <br />INSURER A :Hartford Insurance Company of the Midwest 37478 <br />INSURED <br />SPAY NEUTER ASSISTANCE PROGRAM OF NORTH <br />CAROLINA <br />PO BOX 278 <br />NEW HILL NC 27562-0278 <br />INSURER B : <br />INSURER C : <br />INSURER D : <br />INSURER E : <br />INSURER F : <br />COVERAGES CERTIFICATE NUMBER:REVISION NUMBER: <br />THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD <br />INDICATED.NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS <br />CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE <br />TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. <br />INSR <br />LTR <br />TYPE OF INSURANCE ADDL <br />INSR <br />SUBR <br />WVD <br />POLICY NUMBER POLICY EFF <br />(MM/DD/YYYY) <br />POLICY EXP <br />(MM/DD/Y YYY) <br />LIMITS <br />COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE <br />CLAIMS-MADE OCCUR DAMAGE TO RENTED <br />PREMISES (Ea occurrence) <br />MED EXP (Any one person) <br />PERSONAL & ADV INJURY <br />GEN'L AGGREGATE LIMIT APPLIES PER:GENERAL AGGREGATE <br />POLICY PRO- <br />JECT <br />LOC PRODUCTS - COMP/OP AGG <br />OTHER: <br />AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT <br />(Ea accident) <br />ANY AUTO BODILY INJURY (Per person) <br />ALL OWNED <br />AUTOS <br />SCHEDULED <br />AUTOS BODILY INJURY (Per accident) <br />HIRED <br />AUTOS <br />NON-OWNED <br />AUTOS <br />PROPERTY DAMAGE <br />(Per accident) <br />UMBRELLA LIAB <br />EXCESS LIAB <br />OCCUR <br />CLAIMS- <br />MADE <br />EACH OCCURRENCE <br />AGGREGATE <br />DED RETENTION $ <br />A <br />WORKERS COMPENSATION <br />AND EMPLOYERS' LIABILITY <br />ANY <br />PROPRIETOR/PARTNER/EXECUTIVE <br />OFFICER/MEMBER EXCLUDED? <br />(Mandatory in NH) <br />If yes, describe under <br />DESCRIPTION OF OPERATIONS below <br />N/ A 02 WBC ZS3066 06/06/2021 06/06/2022 <br />X PER <br />STATUTE <br />OTH- <br />ER <br />Y/N E.L. EACH ACCIDENT $500,000 <br />E.L. DISEASE -EA EMPLOYEE $500,000 <br />E.L. DISEASE - POLICY LIMIT $500,000 <br />DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) <br />Those usual to the Insured's Operations. <br />CERTIFICATE HOLDER CANCELLATION <br />Orange County Risk Manager <br />PO Box 8181 <br />HILLSBOROUGH NC 27278 <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED <br />BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED <br />IN ACCORDANCE WITH THE POLICY PROVISIONS. <br />AUTHORIZED REPRESENTATIVE <br />© 1988-2015 ACORD CORPORATION. All rights reserved. <br />ACORD 25 (2016/03)The ACORD name and logo are registered marks of ACORD <br />DocuSign Envelope ID: 2F942916-2917-49B9-AD96-7F46FDC739BE